Safety and Effectiveness of Using CyberKnife on Prostate Cancer Patients Debated - washingtonpost.com

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"This is really pushing the envelope," said L. Zietman, president-elect of the American Society for Therapeutic Radiology and Oncology (ASTRO). "It might be as good and more convenient. It may be better and more convenient. But it could turn out to be a disaster. No one knows."

Proponents argue that enough evidence has accumulated to make them confident that the approach is at least as good as standard therapies and that it can prevent unnecessary deaths by making treatment less daunting. Because the CyberKnife can more precisely target tumors with higher doses of radiation, it could prove even safer and more effective, they say.

"I'm very excited about this," said P. , a town radiation oncologist. "I think it's an important addition to the treatment of prostate cancer. We'll definitely save more lives."

Some critics worry, however, that the push to expand the use of the CyberKnife may be motivated in part by financial incentives: The manufacturer wants to sell more machines, hospitals and private practices want to recover the cost of the systems, and urologists can receive a Medicare payment of about $1,200 for each patient who opts for the therapy.

"Unfortunately, it often comes down to the money," said Louis Potters, who chairs ASTRO's Health Policy Council. "Prostate cancer is so common that it represents low-hanging fruit in terms of revenue opportunities."

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